GUDID 00199150042104

CUSTOM PACK BB12R13R1 HLN SUTT PED

MEDTRONIC, INC.

Cardiopulmonary bypass system blood tubing set

• Primary Device ID: 00199150042104
• NIH Device Record Key: 82538f78-ac93-4361-b8ee-8816d8c2c00e
• Commercial Distribution Status: In Commercial Distribution
• Version Model Number: BB12R13R1
• Company DUNS: 006261481
• Company Name: MEDTRONIC, INC.
• Device Count: 1
• DM Exempt: false
• Pre-market Exempt: false
• MRI Safety Status: Labeling does not contain MRI Safety Information
• Human Cell/Tissue Product: false
• Device Kit: true
• Device Combination Product: false
• Single Use: true
• Lot Batch: true
• Serial Number: false
• Manufacturing Date: false
• Expiration Date: false
• Donation Id Number: false
• Contains Natural Rubber Latex: false
• Labeled No Natural Rubber Latex: false
• RX Perscription: true
• OTC Over-The-Counter: false

Customer Support Contacts

• Phone: +1(800)633-8766
• Email: Corporate.UDI@medtronic.com
• Phone: +1(800)633-8766
• Email: Corporate.UDI@medtronic.com
• Phone: +1(800)633-8766
• Email: Corporate.UDI@medtronic.com

Operating and Storage Conditions

• Storage Environment Temperature: Between 0 Degrees Celsius and 50 Degrees Celsius
• Storage Environment Temperature: Between 0 Degrees Celsius and 50 Degrees Celsius
• Storage Environment Temperature: Between 0 Degrees Celsius and 50 Degrees Celsius

Device Identifiers

Device Issuing Agency	Device ID
GS1	00199150042104 [Primary]

FDA Pre-market Approvals/Notifications & deNovo

• Premarket Notification: K171979

FDA Product Code

• DWF: Catheter, cannula and tubing, vascular, cardiopulmonary bypass

Sterilization

• Steralize Prior To Use: false
• Device Is Sterile: true

Device Entry Metadata

• Public Version Status: New
• Device Record Status: Published
• Public Version Number: 1
• Public Version Date: 2025-09-01
• Device Publish Date: 2025-08-22

Devices Manufactured by MEDTRONIC, INC.

• 00763000004101 - NA: 2025-09-02 COMMUNICATOR TM90T0 TDD PROX
• 00199150042050 - NA: 2025-09-01 CUSTOM PACK SSHY12R43R HLN BB8G55R1
• 00199150042104 - NA: 2025-09-01CUSTOM PACK BB12R13R1 HLN SUTT PED
• 00199150042104 - NA: 2025-09-01 CUSTOM PACK BB12R13R1 HLN SUTT PED
• 00199150042111 - NA: 2025-09-01 CUSTOM PACK BB12Q88R1 HLN INF SUTTE
• 00763000998271 - Affera™ Integrated Mapping System: 2025-09-01 MAP SYS AFR-00016 IMPEDANCE US PLX
• 00199150042005 - NA: 2025-08-29 CUSTOM PACK BB7E29R28 EVL 3/8
• 00199150042012 - NA: 2025-08-29 CUSTOM PACK BB11L88R8 EVL SUPPRT SM
• 00199150042029 - NA: 2025-08-29 CUSTOM PACK BB12P62R3 EVL 1/4